LONDON BOROUGH OF RICHMOND UPON THAMES
Access to Personal Information
Application Form
Dear [Name of Requester]
Under Section 7 of the Data Protection Act 1998 an individual is entitled to ask the London
Borough of Richmond upon Thames (“Council”) for copies of the personal information which
the Council holds about him/her. Subject to certain exemptions under the Act, the Council is
required to provide the individual access to his/her personal information as requested.
To enable the Council to comply with your request to see your personal information, could you
please complete the questionnaire included on this letter and return it to the address at the
bottom of the letter. You will also need to provide us with:
(a)
An original document that verifies your name and address (see Section 6 of the
questionnaire for information about this); and
(b)
Our standard £10 processing fee as set out in Section 7(2)(b) of the Act. This may be
waived at the Council’s discretion.
Your information will be provided within 40 days from the date of receipt of ID and fee.
Please note that under the Act only the following people can request to see personal
information about an individual:

The person whom the information is about (“Data Subject”) – this includes a person
under 18 where they understand the nature of the request;

An agent acting on the Data Subject’s behalf (e.g.: a solicitor); if this is the case then a
letter of consent signed by the data subject is required

The parent or legal guardian of the Data Subject where the Data Subject is under 12 or
lacks sufficient maturity until a later age; in this case proof of parental responsibility
needs to be provided

A person acting under an order of the Court of Protection or acting within the terms of a
registered Lasting Power of Attorney in respect of a person who lacks the capacity to
manage their affairs and make the request themselves.
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SECTION ONE: PLEASE COMPLETE THE DATA SUBJECT’S DETAILS:
Surname: __________________________________________________________
First Name(s): ______________________________________________________
Date of birth: _______________________________________________________
Current Address: ___________________________________________________
__________________________________________________________________
Last Address likely to be known by the Council:
___________________________________________________________________
___________________________________________________________________
SECTION TWO: IF YOU ARE MAKING THE REQUEST BUT ARE NOT THE DATA
SUBJECT, PLEASE PROVIDE YOUR OWN DETAILS:
Full Name: __________________________________________________________
Address: ____________________________________________________________
___________________________________________________________________
SECTION THREE: WHAT DEPARTMENT(S) WITHIN THE COUNCIL HOLD THE
INFORMATION THAT YOU WANT TO SEE?
There may be a number of Departments within the Council that hold personal information
about you or the Data Subject. If you have not already done so, please let us know which
Department’s files about you or the Data Subject you would like to see. For example is it files
held by: Housing Benefits, Human Resources, Parking Services, Social Services (please
specify Adult’s or Children’s) and Children’s Services etc:
Please note that requests for information held only by Children’s Services should be directed
to Achieving for Children directly via:http://www.achievingforchildren.org.uk/contact-us
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Please provide any further details that you believe will assist the Council in locating your
information, for example, the names of any officers within the Council that you believe may
hold relevant information. Please note that the more specific you are with your request and the
more information you provide us, the easier and quicker it is for us to locate your information
and respond to you.
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Please provide the time period for which you are requesting information in respect of (for
example 2010 to date):
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SECTION FOUR: YOU ARE MAKING THE REQUEST BUT ARE NOT THE DATA SUBJECT
If you are, you need to ensure that part (a), (b) or (c) is completed:
(a) Individual acting as agent of the Data Subject (e.g.: solicitor)
The Data Subject must complete the following declaration:
I hereby agree for ________________________________________(Name of agent)
to act on my behalf in relation to my Data Subject access rights under The Data Protection Act
1998
SIGNED ____________________________ DATE_______________________
(b) Parent or legal guardian making application on behalf of person under 12
The parent/legal guardian must complete the following declaration:
I declare that I am the *parent/legal guardian of the Data Subject who is under 12 years
of age (*delete as appropriate)
I am making the Data Subject access request on behalf of _________________
(Name of Data Subject) as the Data Subject, and either:

The child/young person is incapable of understanding the request
OR

The child/young person has consented to my making this request on his/her behalf by
signing below: Please provide proof of your relationship to the child and evidence of your
parental responsibility
SIGNED by parent/guardian:
________________________________________DATE_____________________
SIGNED by child where consented to the request:
__________________________________________DATE____________________
(c) Request made on behalf of an adult incapable of making own request.
The individual with the legal right to make the request on behalf of the Data Subject
must make the following declaration:
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I am making a request on behalf of ________________________ (Name of Data Subject) as
the Data Subject because the Data Subject lacks the required mental capacity to make the
request and is incapable of managing his/her own affairs. In making this request on behalf of
the Data Subject I am either:

Acting under an order of the Court of Protection; or

Acting within the terms of an Enduring Power of Attorney
SIGNED ________________________________ DATE ______________________
[Please provide evidence of the power to act]
SECTION FIVE: ACCESS TO INFORMATION
Please confirm how you would like the information provided to you.
The Council’s preference is for the individual to collect copies of the information from its
offices. This is the most secure option.
Please note that you should provide a reason if you cannot collect the information from the
Council Offices.
Please tick the relevant option.
 I would like to collect the information requested from the Council Offices.
OR
 I would like the information posted to me. There may be a postage fee payable. We will
advise you if this is the case. The reason for this is: ……………………………………………
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The Council generally uses “Egress Switch” as its secure method of sending confidential
information electronically. This can be downloaded free of charge online here. Guidance on
how to use Egress Switch is available at http://www.richmond.gov.uk/egress_switch.
We do not generally consider other email addresses such as Yahoo, bt internet or Gmail to be
secure enough to send personal or confidential information.
 I would like the information emailed to me using my secure email address. The reason for
this is: …………………………………………………………………………………………………..
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And my secure email address is: ……………………………………………………………………..
SECTION SIX: DECLARATION
Before you sign this form and send it to the Council at the below address, please note
the following:
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(a)
Verification of Identity: If you are the Data Subject or are requesting information
about your child who is under 12, please provide us with a form of identification so that we can
verify your identity and ensure that we provide the documents to the right individual. Ideally
you should provide us with photo identification, such as a copy of your passport or driver’s
licence. If your identification does not state your correct address proof of residence can be
provided such as a Council Tax Registration Form, Council or Housing Trust Rent Book,
medical card or utilities bill. For confidentiality reasons you do not need to provide us with any
details on the document other than your name and address/photo.
(b)
What we might not provide you: Under the Act there is some information that we are
entitled to remove from your file(s) prior to giving you access/providing you with copies. We
may also need to obtain the consent of other individuals to the disclosure of their information
to you. Information held about you is exempt from disclosure if it was obtained for the purpose
of—
(a) The prevention or detection of crime, or
(b) The apprehension or prosecution of offenders
Information held about you by Legal Services, is exempt from disclosure if it was collected for
the purpose of, or in connection with, legal proceedings (including prospective legal
proceedings) and for the purpose of obtaining legal advice.
(c)
We may need to contact you for further information before we provide you with the
requested information.
(d)
Have you included the £10 processing fee? If you are in receipt of benefits or if you are
a child we will consider waiving the fee. Please provide us with evidence if you wish us to
waive the fee, for example please provide us with a copy of your benefit entitlement letter
Declaration:
I wish to apply for access to the above named Data Subject's personal information as specified
in this questionnaire. I confirm that to the best of my knowledge the details provided on this
questionnaire are true and correct:
SIGNATURE OF INDIVIDUAL COMPLETING THE FORM:
SIGNED__________________________________ DATE ________________________
ADDRESS TO SEND APPLICATION
Data Protection & Information Officer
London Borough of Richmond upon Thames
Civic Centre
44 York Street
Twickenham
TW1 3BZ
foi@richmond.gov.uk
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